Diabetes Ages the Brain 5 Years Faster than Normal

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People diagnosed with type 2 diabetes in middle age showed greater mental decline than people without metabolic problems.

Having diabetes in middle age appears to set the
mind on a path toward greater cognitive decline, shaving off the equivalent of
five years of brain health. These findings, published in the journal Annals of Internal Medicine, are in line with
previous research showing a link between type 2 diabetes and dementia. The
results reinforce the need for early lifestyle interventions.

“The lesson is that to have a healthy brain when
you're 70, you need to eat right and exercise when you're 50,” said the study’s
lead author, Elizabeth Selvin, an associate professor of epidemiology at the
Johns Hopkins Bloomberg School of Public Health, in a press release. “There is
a substantial cognitive decline associated with diabetes, pre-diabetes, and
poor glucose control in people with diabetes. We know how to prevent or delay
the diabetes associated with this decline.”

Even Pre-Diabetes Can Damage the Brain

To learn how much impact diabetes has on brain health,
researchers followed nearly 16,000 adults with an average age of 57 for more
than 20 years. Thirteen percent of the participants had diabetes at the start
of the study. Over the next two decades, researchers measured the volunteers’ cognitive
function at three separate visits. They also monitored volunteers’ blood sugar
levels using the marker HbA1c, which can be used as an indicator of how well a
person’s diabetes is controlled.

In the study, people diagnosed with type 2
diabetes during middle age showed a 19 percent greater decline in mental ability,
including speed of thinking and executive function, which includes the ability
to plan and to organize information. The researchers estimated that this change
would be similar to the mental decline that normally happens between ages 60
and 65. They calculated that diabetes in mid-life ages the brain about five
years faster than normal.

Researchers also found smaller decreases in mental
ability for people with undiagnosed diabetes and for those with pre-diabetes, or
the early stages of diabetes. The diversity of study volunteers allowed the
researchers to see that all these changes were similar across racial groups.

This is not the first study to link diabetes to age-related
mental decline. Previous research, including a 2012 study in the Internal Medicine Journal, found a connection
between diabetes and dementia. However, the current study suggests that brain changes
may occur in people with type 2 diabetes even before they have progressed to
the point of dementia. Plus, people who have not yet been diagnosed with type 2
diabetes, but are on their way, may be setting the stage for a later loss of brainpower.

Lifestyle Changes Can Offset Diabetes Risk

With a rapidly aging population, the scope of potential
diabetes complications is far-reaching. About 21 million American adults have
been diagnosed with diabetes. In addition, more than one-third of adults in
the United States are obese, and obesity is one of the major risk factors for
type 2 diabetes.

"If we can do a better job at preventing
diabetes and controlling diabetes, we can prevent the progression to dementia
for many people," said Selvin. "Even delaying dementia by a few years
could have a huge impact on the population, from quality of life to healthcare
costs."

While type 2 diabetes can be treated with
medication, lifestyle changes remain an important tool for prevention. These
include taking steps to eat healthily, exercise regularly, quit smoking, and
maintain a healthy weight.

These activities, and others, can not only reduce
the risk of developing type 2 diabetes, but also lower the chances of
developing other complications related to it, such as heart disease, stroke,
high blood pressure, and kidney disease.

"Knowing that the risk for cognitive
impairments begins with diabetes and other risk factors in mid-life can be a
strong motivator for patients and their doctors to adopt and maintain long-term
healthy practices," said study co-author Dr. Richey Sharrett, an adjunct
professor at Johns Hopkins, in a press release.